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    Glaucoma 'renaissance' builds from expanding surgical options


    He devoted the largest part of his talk to MIGS, which he subdivided into internal and external categories. He included in the talk some devices which have not yet received approval from the FDA.

    He further divided the internal MIGS by their outflow targets. Those targeting Schlemm's canal include the Glaukos iStent and iStent inject, the Ivantis Hydrus Microstent, viscodilation, and gonioscopy-assisted transluminal trabeculotomy (GATT).

    They are extremely safe, but require technical skill and their ability to lower IOP is limited by episcleral venous pressure, Dr. Ahmed said. These MIGS are currently used in combination with cataract surgery.

    The outflow target of the Alcon CyPass Micro-Stent and the Glaukos iStent Supra is the supraciliary space. These benefit from a large potential space and are technically intuitive, said Dr. Ahmed. Their effectiveness varies depending on healing. Their IOP results are also modest, and they are also used in combination with cataract surgery.

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